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OVERVIEW OF PROGRESS ON HEALTH CARE WITH REFERENCE TO MDGs IN SOUTH ASIA (5th ARM, 23-24 January 2006, Agra) India Experience OneWorld South Asia, New Delhi www.oneworldsouthasia.net Health Sector Covers • Hospitals • Clinics • Nursing Homes • Civil Infrastructure • Doctors • Paramedical Staff • Medicines/Drugs • Equipments & Devices • Chemist Shops • Maintenance Issues • Limited Public Resources Plan Outlay For Health During 3rd Plan 1961-66 was only 2.6%, Reduced To 1.4% In 1997-2002 Now, Government Spending Is 0.9% of GDP • Poor quality of services through public health infrastructure Sub centres, PHCs, CHCs, district hospitals & tertiary hospitals Doctors, paramedical staff Medicines, devices and equipments Monitoring – eg TB Poor maintenance Poor accessibility (distance) and affordability (including transportation) Issues contd ….. • Conflict of interest of different systems of medicine Allopathy Ayurvedha Siddha Unani Homeopathy • Disease burden Diarrhoea – leading cause of child deaths; 19.2% children below the 3 years of age suffer from diarrhoea 35% of infants are not fully immunised – 90% in Bihar, 81% in UP TB – cases 85 lakhs; 2 lakhs die each year HIV/AIDS cases 51 lakhs Cancer – 75 lakhs diagnosed each year Cardiovascular diseases – 3.8 crores Diabetic patients – 3.3. Crores; 50,000 loose their legs Mental disorders – 6.5 to 7 crores Disease Burden - India contd ….. Potential interventions • 80% provided by private sector • of health service providers – medical, nursing, pharmacy councils, drug quality control Pre-natal diagnostic techniques (PNDT) Act, amended in Feb 2003 • Prohibits and disclosure of sex of the foetus • Prohibits advertisements • Punishable with imprisonment and fine National rural health mission (NRHM), 2005 • Give more powers to the village councils • Availability and accessibility of quality healthcare especially for the rural people, poor, women and children • To cover 3,00,000 villages • To revitalise local health traditions – ISM, AYUSH • Success depends on alertness of civil society • Golden triangle partnership mission to develop drugs for 13 specific diseases • National health programmes – TB, leprosy, HIV/AIDS, etc. Some ICT experiences • E-health cards – Sirsa, Haryana • Info-kiosk: n-Logue – Aravind Eye Hospital, Madurai • Telemedicine • Ek Duniya Sawal Jawab: IVRS technique – Drishtee, Haryana and Bihar; Tarahaat, UP and MP • Phone-in radio programmes: Aravis, Gurgaon, Haryana • Dgroups: Pro-poor hiv/aids strategies www.dgroups.org/groups/hiv-aids What MSPs can do? • Interface with governments, NGOs/CSOs and community through multi-stakeholder partnership model (MSP) • Disease surveillance and monitoring • Facilitate in sourcing content from the society (pull) • Disseminate content (push) from NGOs/CSOs, Govt., to the community • Capacity building • Assess community needs, then develop/use suitable tools